<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320088
Report Date: 03/22/2022
Date Signed: 03/22/2022 04:50:27 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/15/2021 and conducted by Evaluator Stephanie Cifuentes
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20211115145943
FACILITY NAME:CLEARVIEW TREATMENT PROGRAMFACILITY NUMBER:
198320088
ADMINISTRATOR:GHERNA, ELIZABETHFACILITY TYPE:
735
ADDRESS:2474 GLYNDON AVENUETELEPHONE:
(310) 344-5134
CITY:VENICESTATE: CAZIP CODE:
90291
CAPACITY:6CENSUS: 5DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
12:59 PM
MET WITH:Emily Osbourne-QATIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility does not have a certified Administrator.
Facility is understaffed.
Facility is in disrepair.
Medication's are not being administered to residents according to physician's orders.
Facility is dirty.
Facility staff are not adequately trained
Facility has bed bugs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced subsequent complaint investigation at above facility. LPA spoke to Program Director Stephen Rudoy, who stated facility has no covid-19 cases and there are no signs or symptoms. LPA Cifuentes arrived at the facility and was greeted by staff Emily Osbourne. LPA explained purpose of visit was to deliver findings for the allegations listed above and was allowed entry to the facility.

The investigation consisted of the following: On 11/19/2021 LPA conducted initial 10 day visit, met with Director Steven Rudoy and completed a walkthrough of facility. On 12/15/2021 LPA interviewed client 1 – client 3 (C1-C3), Staff 1-Staff 7 (S1-S57). LPA reviewed and requested copies of the staff schedule and other documents in association with the allegations.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 7
Control Number 11-AS-20211115145943
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAM
FACILITY NUMBER: 198320088
VISIT DATE: 03/22/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Facility does not have a certified Administrator.
It is alleged that facility administrator Elizabeth Gherna is out of state and not actively working as facility administrator. LPA spoke to Steven Rudoy, Executive Director of Clearview Treatment Programs, who stated Liz Gherna was the Administrator, but that she had been moved to other duties, so they had instated Jasmine Lucas as administrator. Ms. Gherna’s administrator license expired on August 31, 2021. Per Dr. Rudoy, Ms. Lucas was taking the classes to satisfy the requirements for a certified administrator and had submitted the documentation to CCLD. Per Community Care Licensing Administrator Certification unit, packet was received for Jasmine Lucas on 10/8/2021. LPA was notified on 11/16/2021 that Ms. Lucas would no longer be administrator and that Leilani Le would be taking the classes to become a certified administrator. As of 3/22/2022 LPA Cifuentes was able to confirm that the administrator certification section has received an administrator packet for Leilani Le but are behind on processing it. LPA was unable to confirm when the payment for the certification was cashed or if there have been any other delays in processing due to the holidays or Covid-19 pandemic. LPA interviewed staff 1-staff 7 regarding allegations. When asked if the facility had an administrator, three named the past administrator Liz Gherna, one named Jasmine, two were unsure and one named the house administrator. LPA spoke to clients 1-client 3 regarding allegation, one named a house administrator and the other two were unaware an administrator was needed.
Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above

Allegation: Facility is understaffed.
It is alleged that staffing ratios are below requirements causing quality of care concerns with clients amongst other issues. LPA reviewed facilities program plan, which does not give a specific ratio of staff to residents, it does however discuss the continuous monitoring and supervision of clients. LPA Cifuentes spoke to Emily Osbourne regarding the Ratio of staff to residents. Per Ms. Osbourne, there is no set ratio, the amount of staff needed is based on client’s acuity but that she felt there were enough staff to see to the needs of the clients in care. LPA reviewed the staff schedule for November 1 to November 14, which showed two staff on the AM and PM shifts and one staff overnight. When LPA was touring facility, she saw two staff, and later on met the house administrator. LPA asked facility clients if they believed the facility had enough staff. Two out of the three clients interviewed stated facility did not have enough staff. LPA Cifuentes spoke with facility staff, of the seven questioned, three stated there where days they felt they were short of staff, while the other four stated they thought the facility had enough staff.
Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.
Continued on 9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 11-AS-20211115145943
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAM
FACILITY NUMBER: 198320088
VISIT DATE: 03/22/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Facility is in disrepair.
Complainant alleges that facilities refrigerator, washer and dryer are broken. LPA Cifuentes toured facility grounds on 11/19/2021. House appeared clean, indoor and outdoor passageways were free of obstructions, lights all operated properly as did sinks and toilets and bed had all required linens. LPA checked and the fridge was operating. LPA spoke with clients 1-3 regarding the allegation. Out of the three interviewed, all three residents stated they believed the facility to be in good repair and that the washer, dryer and refrigerator are in working order. LPA interviewed staff regarding the allegation. Of those interviewed, 7 out of 7 staff stated that facility is in good repair. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

Allegation: Medications are not being administered to residents according to physician's orders.
Complainant alleges that there are constant medication errors and medications are not received as necessary. LPA Cifuentes reviewed medication administration log for residents and found no inconsistencies. LPA spoke with clients regarding the allegation. Out of the three interviewed, all three residents stated their medications are being given timely and correctly. LPA interviewed staff regarding the allegation. Of those interviewed, 7 out of 7 staff stated that medications are given timely and correctly. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above

Allegation: Facility is Dirty
Complainant alleges the facility is dirty, that bedrooms and bathrooms do not get cleaned due to staff shortages. LPA Cifuentes toured facility grounds on 11/19/2021. Bedrooms, bathrooms and kitchens appeared clean, indoor and outdoor passageways were free of obstructions. LPA spoke to Dr. Stephen Rudoy, who states a cleaning service comes once a week, then as needed they come more often, in the future they will be coming twice a week. Little things are handled by the staff. LPA spoke with clients regarding the allegation. Out of the three interviewed, all three clients stated they believed the facility was clean. LPA interviewed staff regarding the allegation. Of those interviewed, 7 out of 7 staff stated that facility grounds are clean. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

Continued on 9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 11-AS-20211115145943
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAM
FACILITY NUMBER: 198320088
VISIT DATE: 03/22/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Facility staff are not adequately trained.
Complainant alleges that staff training in general and particularly CPR training is not up to standard. LPA Cifuentes reviewed facility records and found current CPR certifications for facility staff. LPA also reviewed facility files and found that staff received basic training during their onboarding and throughout the year. LPA spoke with clients regarding staff training. All three clients interviewed stated they believed most of the staff was well trained. LPA interviewed staff regarding allegation. Four of those questioned did not know anything about staff training and two stated that they received training in the kitchen or food handlers’ certificate. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.


Allegation: Facility has bed bugs
Complainant alleges the facility has bed bugs, LPA Cifuentes toured facility grounds on 11/19/2021. LPA checked beds and did not find traces of bed bugs either alive or dead. LPA spoke to Dr. Stephen Rudoy, who states pest control came out to inspect facility as they were told a bed bug had been found. LPA reviewed post visit inspection log from Mel’s Property Maintenance, which stated house was inspected for bed bugs in all rooms and did not find any signs of bed bugs but they did find spiders. Maintenance service recommended treatment and removal of spiderwebs. LPA spoke with clients regarding allegation and out of the three interviewed, all three clients stated the facility did not have bed bugs, but one of them was being bitten by something. LPA interviewed staff regarding the allegation. Of those interviewed, 7 out of 7 staff stated that the facility does not have bed bugs. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

The Department’s investigation consisted of an inspection of the facility, observation, analysis of residents records, incident report, and interviews conducted and found no evidence to support the allegations: “Facility does not have a certified Administrator,” “Facility is understaffed,” “Facility is in disrepair.” Medications are not being administered to residents according to physician's orders” “Facility is Dirty,” “Facility staff are not adequately trained,” Facility had bed bugs”. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations, did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview conducted, and a copy of the report was given to Steven Rudoy, Executive Director.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/15/2021 and conducted by Evaluator Stephanie Cifuentes
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20211115145943

FACILITY NAME:CLEARVIEW TREATMENT PROGRAMFACILITY NUMBER:
198320088
ADMINISTRATOR:GHERNA, ELIZABETHFACILITY TYPE:
735
ADDRESS:2474 GLYNDON AVENUETELEPHONE:
(310) 344-5134
CITY:VENICESTATE: CAZIP CODE:
90291
CAPACITY:6CENSUS: 5DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
12:59 PM
MET WITH:Emily Osbourne-QATIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unqualifed staff administering medications to residents in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced subsequent complaint investigation at above facility. LPA spoke to Program Director Stephen Rudoy, who stated facility has no covid-19 cases and there are no signs or symptoms. LPA Cifuentes arrived at the facility and was greeted by staff Emily Osbourne. LPA explained purpose of visit was to deliver findings for the allegations listed above and was allowed entry to the facility.

The investigation consisted of the following: On 11/19/2021 LPA conducted initial 10 day visit, met with Director Steven Rudoy and completed a walkthrough of facility. On 12/15/2021 LPA interviewed client 1 – client 3 (C1-C3), Staff 1-Staff 7 (S1-S57). LPA reviewed and requested copies of the staff schedule and other documents in association with the allegations.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 11-AS-20211115145943
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAM
FACILITY NUMBER: 198320088
VISIT DATE: 03/22/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Unqualified staff administering medication to residents in care.
Complainant alleges that staff training in medications is not adequate. LPA reviewed medication training, which was conducted by facilities Quality Compliance officer Emily Osbourne and not a licensed professional. Per Emily Osbourne, facility has a nurse who currently completes medication training. The nurse started working in September and has not redone medication training for all of the staff. LPA spoke with clients regarding staff training. All three clients interviewed stated they believed most of the staff was well trained. LPA interviewed staff regarding allegation. Four of those questioned did not know anything about staff training and two stated that they received training in the kitchen or food handlers’ certificate. Based on information gathered, the Department did find sufficient evidence to support the allegation mentioned above

California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of the LIC 9099 and appeal rights forms were provided to Compliance Coordinator Emily Osbourne.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 11-AS-20211115145943
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754

FACILITY NAME: CLEARVIEW TREATMENT PROGRAM
FACILITY NUMBER: 198320088
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/19/2022
Section Cited
CCR
80075(b)(1)(A)
1
2
3
4
5
6
7
HEALTH-RELATED SERVICES
The licensee shall ensure that each client receives necessary first aid and other needed medical...services, including...Facility staff must receive training from a licensed professional.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will insure licensed proffesional completes medication trainig for all facility staff. Copy of course outline and sign in sheet will be faxed to LPA Cifuentes by POC due date.
8
9
10
11
12
13
14
On 11/19/2021 LPA Cifuentes noted during an interview, that medication trainiing was conducted by Compliance Officer not a licensed proffesional. This is a potential risk to the health of the clients in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 7 of 7